Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Cleanliness

  • Is the Room Clean?

Painting - Walls, Ceiling & Flooring

  • Wall 1 Condition

  • Wall 2 Condition

  • Wall 3 Condition

  • Wall 4 Condition

  • Ceiling Condition

  • Under Desk Condition

  • Skirting Condition

  • Flooring Condition

Doors, Windows & Lighting

  • Spy Hole - In place and Secure?

  • Window - Is the Window Safe, Secure and Free from Damage? Check Glazing, Frame, Handles and Hinges.

  • Door Stop - In place and Secure?

  • Fire signage on door and correct for Location?

  • Door Closure - Fully operational?

  • Curtains - General Condition

  • Curtains - Hooks Missing or Damage?

  • All Lighting Working?

Furniture

  • Bed - Mattress Condition

  • Bed - Frame Secure?

  • Deskchair - In place and free from Damage?

  • Bedroom Bin - In place and free from Damage?

Waste

  • Excessive Waste to remove?

  • Personal Belongings to Store/Report to Uni?

  • Personal Belongings to dispose via Charity Bins?

Bathroom

  • Walls - General Condition

  • Flooring - General condition

  • Toilet - General Condition

  • Toilet - Check Flush, Toilet seat and Flush Button/Handle

  • Toilet - Any Other Issues?

  • Mirror - Free from cracks, excessive wear or damages?

  • Basin - Taps working and secure? Check pressure.

  • Basin - Basin free from cracks and Plug in place?

  • Basin - Any Other Issues?

  • Shower - General Condition

  • Shower - Showerhead in place and secure? Check pressure.

  • Shower - Check water drains away quickly.

  • Shower door/curtain - Condition

  • Shower - Any Other Issues?

  • Door and Handles - In full working order?

  • Coat Hooks - In place and secure?

  • All Lighting Working?

Any Other Issues

  • Additional Issue 1

  • Additional Issue 2

  • Additional Issue 3

  • Additional Issue 4

  • Additional Issue 5

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.